Health Ombud rules out workplace bullying as cause of KZN healthcare worker deaths
The Health Ombud, Professor Taole Mokoena, has found no direct causal link between the deaths of healthcare professionals investigated in KwaZulu-Natal and workplace bullying, victimisation or adverse working conditions, but warned that serious systemic challenges continue to affect healthcare workers across the province.
Mokoena made the findings public during a media briefing on Wednesday, where he released the report of a joint investigation into the six deaths of healthcare professionals at public hospitals in KwaZulu-Natal.
The investigation, conducted with the assistance of the Public Service Commission, followed complaints lodged by Health Minister Dr Aaron Motsoaledi and former chairperson of Parliament’s Portfolio Committee on Health, Dr Sibongiseni Dhlomo, amid public concern and extensive media reports surrounding the deaths.
Mokoena said the investigation sought to establish whether workplace conditions, human resource practices or broader systemic challenges contributed to the deaths.
“The overall findings are as follows. The investigation found no evidence pointing to direct causal link between the deaths under the investigation and workplace bullying, victimisation, adverse working conditions at any of the facilities concerned.”
He said this finding did not mean the public health system was without serious challenges.
“The finding is not to mean that the health system is free of serious challenges. On the contrary, the investigation uncovered significant systemic concerns affecting healthcare professionals across multiple health establishments.”
Mokoena said the investigation identified persistent staffing shortages, frozen vacant posts, excessive workloads, shortages of medical equipment and supplies, infrastructure challenges, inadequate employee wellness support and security concerns affecting healthcare workers.
“These issues require urgent attention because they affect both the health workers and indirectly the quality of care provided to the public.”
The investigation examined the deaths of healthcare professionals at Addington Hospital, Port Shepstone Hospital, Ngwelezane Hospital, Vryheid Hospital, Prince Mshiyeni Memorial Hospital and Benedictine Hospital.
Mokoena said investigators reviewed hospital records, human resource practices, employee wellness programmes and disciplinary records, while conducting interviews with hospital management, healthcare professionals, interns, labour representatives and support staff.
On the death of Dr Tumelo Kgaladi, a 31-year-old doctor who died at his residence while not on duty at Addington Hospital, Mokoena said the investigation found no causal link between his death and his working conditions.
He said there was circumstantial evidence suggesting possible carbon monoxide poisoning, but the final determination of the cause of death remained subject to a forensic South African Police Service inquiry and inquest process.
Mokoena said the investigation found that Dr Kgaladi had a history of mental health problems that had not been disclosed to the hospital.
He said the probe identified staff shortages, heavy workloads, gaps in employee wellness support and medical surveillance processes at the hospital.
The investigation also found no link between the death of radiographer Mvelo Cele at Port Shepstone Hospital, who died from cardiac arrest while on duty, and workplace conditions.
Mokoena said the hospital nevertheless faced staffing challenges, including the loss of specialists and difficulties filling posts because of budget constraints.
In the case of Dr Siyabonga Zulu of Ngwelezane Hospital, who died in a motor vehicle accident while off duty, Mokoena said there was no evidence linking his death to workplace conditions or systemic issues at the hospital.
He said the investigation did, however, identify challenges including staff shortages, security concerns and inadequate employee wellness capacity.
Mokoena also addressed allegations surrounding the death of Dr Francis Idika of Vryheid Hospital, where claims had suggested workplace bullying, victimisation and disciplinary action contributed to his death.
He said the investigation did not support those allegations and found that Dr Idika died from natural causes after suffering a ruptured aortic aneurysm.
However, the investigation identified governance failures in the handling of complaints, disciplinary matters and workplace conflicts at the hospital.
On the death of Dr Alulutho Mazwi, a medical intern at Prince Mshiyeni Memorial Hospital, Mokoena said claims circulating on social media that he had been instructed to report for duty despite being ill were fabricated.
“He became critically ill one night while at his hospital doctors’ residence and was rushed to the hospital medical emergency room, where he was pronounced dead on arrival.”
Mokoena said the most likely cause of Dr Mazwi’s death was pulmonary embolism from deep vein thrombosis.
He said the investigation found concerns around support systems available to interns and identified a culture among some junior doctors of fearing to take sick leave because of concerns about extending internship rotations or increasing workloads for colleagues.
The Health Ombud also addressed the death of Dr S.I. Ngidi, a community service doctor at Benedictine Hospital, saying the investigation found that he died by suicide after ingesting rat poison while off duty.
Mokoena said the investigation established that Dr Ngidi was not directly involved in the fraudulent birth registration matter that had implicated his name.
He said weaknesses were identified in document control processes at the hospital, including pre-signed blank birth registration forms, and the matter had been referred to law enforcement authorities.
Mokoena said healthcare professionals consistently raised concerns about burnout, increased workloads, limited mental health support, workplace safety concerns and infrastructure challenges.
He said many employee wellness programmes were under-resourced and unable to adequately meet the needs of healthcare workers.
“The system cannot effectively care for patients if it fails to adequately support those who provide the healthcare.”
Mokoena also raised concerns that chief executive officers at some hospitals were not medically trained, saying this created a conflict of authority within those establishments.
He said the Health Ombud had made recommendations aimed at strengthening employee wellness programmes, improving staff support systems, addressing security concerns, enhancing oversight and accountability, and ensuring compliance with prescribed norms and standards for healthcare establishments.
“The release of this report, and of many others before it, does not mark the end of the process, but rather it forms part of a continuum in a journey to build and maintain a safe, responsive, quality healthcare service delivery in this country.”
Mokoena said the findings and recommendations would be referred to the Office of Health Standards Compliance for monitoring and implementation, with the Health Ombud continuing to work with the office to ensure improvements in healthcare worker well-being, patient safety and quality of care.
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